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General NPI Number Information
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NPI Number | 1750852984
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Entity Type | Individual
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Provider Name | BRYCE COPE
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Gender | Male
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 1717 WILL O WISP DR STE 200
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3102
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Country | US
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Telephone | 757-481-4817
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Fax |
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Provider Business Mailing Address
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Address Line | 2356 ESPLANADE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-6527
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 0110-006662
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number | 0110-006662
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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